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Anorexia nervosaThis factsheet is for people who have anorexia nervosa or for friends and family of people with anorexia nervosa. Anorexia nervosa, often abbreviated to anorexia, is an eating disorder where people have an intense fear of putting on weight. They severely limit the amount of food they eat to reduce their body weight to an unhealthily low level. Anorexia is most common in teenage girls aged 13-19, although anyone can develop the illness at any age. Anorexia can be treated with psychotherapy and diet advice but these are only effective if the person is ready to get better. Untreated, anorexia can lead to serious health problems. What is anorexia?Anorexia nervosa means 'loss of appetite for nervous reasons' but in fact you do not lose your appetite if you have anorexia, you just don't allow yourself to satisfy your appetite. People with anorexia have a distorted notion of their body shape and image. They try to avoid or limit eating and may also over-exercise so become very underweight. About 1 in 200 women and 1 in 2000 men get anorexia at some time in their lives. Boys and men do appear to be getting eating disorders more often. The other main eating disorder is bulimia nervosa, which is characterised by cycles of bingeing (overeating) and purging (ridding the body of the excess food usually by vomiting or laxatives). For more information, please see the separate BUPA factsheet Bulimia nervosa. Some people with anorexia may have bingeing and purging habits too.
SymptomsPeople with anorexia may have some or all of the following symptoms:
Health problems caused by anorexiaApart from weight loss, the physical signs of starvation can include:
If a person with anorexia vomits after they've eaten, they may have other problems such as discoloured teeth, bad breath and heartburn. Over time, anorexia can cause serious long-term health problems such as:
If people with severe anorexia do not receive appropriate treatment, they may die from related health problems. CausesThe cause of anorexia isn't fully understood at present. It may develop due to a combination of emotional, physical and social triggers. The precise reasons for developing it are thought to be different for each person. Certain personality traits are common in people with eating disorders, which include:
An eating disorder may bring a sense of control and achievement to certain people with these personality traits. There are certain factors that may make a person more likely to develop anorexia including the following:
DiagnosisGetting help is very important. For people with anorexia, admitting that they have a problem is the first, yet hardest, step. If they take that step, they can find the support and treatment they need to stop anorexia taking over their lives. A GP is the first point of contact for help. He or she will ask about the patient's life and eating habits and will examine them to check for any physical problems resulting from anorexia. He or she may refer the patient to a psychiatrist or psychologist who is trained in treating people with eating disorders. TreatmentA person with anorexia can be helped much more easily if the problem is identified and treated early. However, for treatment to be successful, he or she must be ready to get better. The aim of treatment is to re-establish a healthy attitude towards food and a consistent pattern of eating, with three meals a day at regular times. Healthy eatingKeeping a diary of eating habits to discuss with a GP and learning about healthy eating and sensible weight control may be helpful. For more information about maintaining a healthy diet, see the separate BUPA factsheet:
Drug treatmentsThere are no drugs that can cure anorexia. Some people need medicines to treat other health problems caused by anorexia, such as oestrogen hormone supplements in adults if their bones are weak because of anorexia. Talking treatmentsA type of talking treatment, or psychotherapy, called cognitive behavioural therapy (CBT) is frequently used. CBT allows people to talk through the issues that upset them and that may lie at the heart of their eating disorder. CBT can help people to learn healthier ways of thinking about food. For more information about CBT, please see the separate BUPA factsheet:
Self-help groups may also be helpful. It is often comforting to talk to other people who have been through the same thing, and who can offer understanding and acceptance without blame or guilt. Therapy involving the family may also be helpful, especially when a younger child has anorexia. This helps everyone in the family to support each other. Hospital treatmentMost people who have anorexia can be successfully treated without being admitted to hospital. However, if excessive weight loss has put someone's life at risk, hospital may be considered for fluid and other nutrient replacement. Compulsory treatment is always a last resort, because it is distressing for people with anorexia to lose control over what they eat and drink. How can family and friends help?It can be upsetting to witness loved ones putting their health at risk and it is natural to want to help. But unwanted pressure or criticism from others usually makes matters worse. Try to let the person make his or her own choices and let the person know that love and support is consistently there. Once the person has recognised the problem, offer to help with practical matters such as finding medical assistance, self-help groups and other resources that may be needed to help them get over anorexia. Recovering from anorexiaIt is possible to recover from anorexia, although it can be a long process. People may have relapses in times of stress. Anorexia is difficult to overcome, but with commitment, patience and support it can be done. Further information
References
Reviewed by Dr Adrian Winbow, MB, FRCPysch, DPM, consultant psychiatrist, Godden Green Clinic, Godden Green, BUPA Hartswood Hospital and BUPA Hospital Tunbridge Wells. Published by BUPA's health information team, healthinfo@bupa.com, October 2005
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